Regaining Your Quality of Life After Spinal Cord Injury

How do doctors measure quality of life, and what helps or harms QOL after spinal cord injury?

Written by Michael G. Fehlings, MD, PhD, FRCSC, FACS

Your life changes after a spinal cord injury (SCI), but that doesn’t mean achieving a good quality of life is out of reach. Several factors impact your quality of life after SCI—and your level of independence, social support network, and employment status play a meaningful role.
How Do Doctors Measure Quality of Life After Spinal Cord Injury?
Spine doctors have several tools to measure your quality of life after SCI, and you may be asked to participate in these assessments throughout your care.

The most common SCI quality of life assessments are the Satisfaction with Life Scale (SWLS) and the 36‑Item Short-Form Health Survey (SF‑36).

Your doctor may also use a newer tool specifically designed to measure quality of life (QOL) after SCI called the SCI-QOL, which covers the whole spectrum of well-being—including physical, emotional, and social health.

What Helps—and Harms—Quality of Life After Spinal Cord Injury?
While people with SCI have been shown to have a lower quality of life than the general population, that doesn’t mean you will have a low quality of life after a traumatic injury. Several factors affect your quality of life after SCI.

Factors associated with low quality of life
Studies are mixed when determining which factors have the most impact on quality of life.

One study found that handicap, defined as a disadvantage in acting in a certain role, was most associated with lower quality of life after SCI. Functional impairment (defined as the loss or abnormality of bodily function) and disability (a bodily limitation for certain activities) had a smaller impact on quality of life.

Other studies show that the severity and level of injury have the most impact on your quality of life after SCI. In other words, if you have a high-level (eg, cervical spine), severe injury, you have a higher chance of a lower quality of life. But, some studies show this isn’t necessarily the case.

The following factors are also associated with low quality of life after SCI:

Factors associated with higher quality of life

The Financial Burden of Spinal Cord Injury Weighs Heavily on Quality of Life
The financial toll of SCI has a significant impact on quality of life.

The health care costs and living expenses directly related to SCI vary greatly based on where you live, your age, and the severity of your injury.

Getting the right treatment as soon as possible after the traumatic event has a major effect on reducing these costs. Early treatment greatly increases the chance of restoring or improving function, which results in lower lifetime costs.

A Closer Look at Average Lifetime Costs of Spinal Cord Injury
While annual expenses and estimated lifetime costs from SCI vary greatly from patient to patient, the figures below give you a snapshot of the financial impact of SCI. These estimates do not include any indirect costs, such as lost wages, benefits, and productivity, which average $72,955 per year.

A note about reading this table: Under the “Severity of Injury” column, AIS refers to the ASIA Impairment Scale, which grades the severity of nerve damage following SCI. Grades are labeled A, B, C, D, or E. You can read more about the ASIA Impairment Scale in Spinal Cord Injury Classification and Syndromes.
A Focus on Improving Quality of Life After Spinal Cord Injury
Spine researchers are continuously making strides in better understanding spinal cord injury to help people affected by these injuries lead healthier, happier lives. Clinical trials and innovative therapies are integral to improving the quality of life for people who endure traumatic SCI.

Suggested Additional Reading
A special issue of the Global Spine Journal set forth guidelines for the Management of Degenerative Myelopathy and Acute Spinal Cord Injury, which is summarized on SpineUniverse in Summary of the Clinical Practice Guidelines for the Management of Degenerative Cervical Myelopathy and Traumatic Spinal Cord Injury.

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Spinal Cord Injury Classification and Syndromes